A University of Pittsburgh research group, Pharmacy Evaluation and Research Unit (PERU), has developed a novel educational tool, SBIRT (Screening, Brief Intervention, Referral to Treatment) and Obstetrics. The tool is designed to recognize and manage substance use including alcohol, cigarettes, and illicit substances during pregnancy – to arm clinicians with the knowledge needed to screen for substance use in pregnant people and understand the impact (including misuse and dependency). Ultimately, this educational approach will empower clinicians to engage with patients by building rapport for honest and open conversations. Recognizing substance use during pregnancy can lead to harm reduction interventions, improving pregnancy outcomes and child health.
Description
Substance use during pregnancy can have negative impacts on maternal health and fetal development, leading to neonatal complications and potentially lifelong difficulties for the child. Despite these risks, in the US around 10% of pregnant people use substances, resulting in tens of thousands of neonatal hospital admissions for conditions including drug withdrawal and fetal alcohol syndrome. There is a great public health need to identify pregnant people most at risk of substance use, to intervene and address the subject sensitively, and support the patient with harm reduction strategies. SBIRT and Obstetrics has been specifically tailored to healthcare professionals (HCPs) working in primary care settings to arm them with the ability to screen for substance use and provide education to address this issue in pregnancy.
Applications
• Prenatal health
• Obstetrics training
• Community and primary care provider (PCP) training
Advantages
Pregnancy is associated with increased motivation to change and adopt healthier lifestyles. During pregnancy, regular visits to an HCP are required for prenatal care, making this an ideal environment to screen for substance use. This training provides increased awareness for HCPs to ensure they can comfortably screen patients during pregnancy and discuss the subject in an open and supportive manner. Clinicians’ understanding of potential treatment strategies are also improved, and HCPs can recognize social and other barriers to interventions. Offering patients tailored options to manage substance use at a time of increased motivation to change has the potential to improve chances of success during pregnancy and beyond.
Invention Readiness
A training program has been developed aimed specifically at HCPs in PCP settings. HCPs learn to apply SBIRT in obstetrics. Using validated screening tools, clinicians can identify patients most at risk of substance use in pregnancy, engage with patients and suggest brief interventions, including gestational stage-specific interventions, based on the patient’s own goals and circumstances. Importantly, HCPs learn compulsory treatment may increase harm. Additionally, this course educates HCPs to assess other health concerns including infection, interpersonal violence, sex work, eating disorders, and psychiatric problems to further support and reduce harm in patients.
IP Status
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